Skip to main content
  • Fertilité et Sexualité du Paraplégique
  • Published:

Spermatogénèse et Paraplégie

Male fertility and paraplegia

Resume

Dans cet article, vont être passées en revue les possibilités de procréation du paraplégique.

Un premier chapitre traitera du fonctionnement testiculaire avec l’étude des dosages hormonaux et de l’histologie testiculaire (étude portant sur 100 patients). Au vue de la biopsie testiculaire, il y a une lésion exocrine, d’origine neurologique, parfois irréversible. Par contre, les lésions du testicule endocrine ont été réversibles sous stimulation ou spontanément.

Un deuxième chapitre traitera des différentes techniques pour obtenir une éjaculation et l’analyse du spermogramme. Les techniques utilisées étant: le vibro-massage, l’électro-éjaculation, l’éjaculation par stimulation pharmacologique. L’étude porte sur 124 tests éjaculatoires, pour lesquels ont été obtenues 64 éjaculations antégrades (52%) et 4 éjaculations rétrogrades (3%). Le spermogramme obtenu a montré une numération des spermatozoïdes supérieure à 20 millions par ml dans 35 cas (soit 51,5%) et inférieure à 5 millions dans 11 cas (soit 16%).

Abstract

In this article, the paraplegics’ possibilities for procreation will be examined.

A first chapter will deal with the testicle functioning along with the study of hormonal measuring and testicle histology (study involving 100 patients). As a result, it appears that, after a testicle biopsy, there is a testicle lesion of neurological origin that is sometimes irreversible.

On the contrary, the endocrinal testicle lesions have proved reversible under stimulation or spontaneously.

A second chapter will deal with the different techniques to obtain an ejaculation and the semen analysis.

The techniques that were used being: massage by vibrator, electroejaculation, ejaculation through pharmacological stimulation. The study focuses on 124 ejaculatory tests among which 64 forward ejaculations (52%) and 4 bachward ejaculations (3%) were obtained. The resulting semen analysis revealed a spermatozoon count greater than 20 millions per millilitre (that is 51,5%) and smaller than 5 millions in 11 cases (16%).

References

  1. BECKERMAN H., BECHER J., LANKHORST G.J.: The effectiveness of vibratory stimulation in anejaculatory men with spinal cord injury. Review article. In: Paraplegia, 1993, 31: 689–699.

  2. BERARD E., PERRIN B., LERICHE A., MINAIRE P., GIRARD R., BOURRET J.: Semiological value of painful sensitivity of the testis and spinal cord injuries. In: Paraplegia, 1978–1979, 15: 373–378.

  3. BERETTA G., CHELO E., ZANOLLO A.: Reproductive aspects in spinal cord injured males. In: Paraplegia, 1989, 27: 113–118.

  4. BORS E., ENGLE T., ROSENQUIST C., HOLLIGER V.H.: Fertility in paraplegic males. A preliminary report of endocrine studies. In: J. Clin. Endoc., 1950, 10: 381–398.

    Google Scholar 

  5. BRINDLEY G.S.: The fertility of men with spinal cord injuries. In: Paraplegia, 1984, 22: 337–348.

  6. BRINDLEY G.S.: Reflex ejaculation under vibratory stimulation in paraplegic men. In: Paraplegia, 1981, 19, 5: 299–302.

  7. BRINDLEY G.S., SAUERWEIN D., HENDRY W.F.: Hypogastric plexus stimulators for obtaining semen from paraplegic men. In: Br. J. Urol., 1989, 64: 72–77.

  8. CHAPELLE P.A. et al.: Neurological correlations of ejaculations and testicular size in men with complete spinal cord section. In: J. Neurol. Neurosur. Psychiat., 1988, 51: 197–202.

  9. CHAPELLE P.A., JONDET M., DURAND J., GROSSIAD A.: Pregnancy of the wife of a complete paraplegic by homologeous insemination after an intrathecal injection of neostigmine. In: Paraplegia, 1976, 14: 173–177.

  10. COMARR E., A., BORS E.: Spermatocystography in patients with spinal cord injuries. In: J. Urol., 1955, 73, no1: 172–178.

  11. DALAGE C., TANCHE M.: Effects de la destruction de la moelle épinière sur le conditionnement testiculaire du chien. In: J. Physiol. Paris, 1959, 51: 441–442.

    Google Scholar 

  12. ENGH E., CLAUSEN O.P.F., PURVIS K., STIEN R.: Sperm quality assessed by flow cytometry and accessory sex gland function in spinal cord injured men after repeated vibration-induced ejaculation. In: Paraplegia, 1993, 31: 3–12.

  13. FRANCOIS N. et al: L’éjaculation par le vibromassage chez le paraplégique à propos de 50 cas avec 7 grossesses. In: Ann. Med. Phys., 1980, 23: 24–36.

  14. GUTTMANN L., WALSH J.J.: Prostigmine assessement test of fertility in spinal man. In: Paraplegia, 1971, 1: 39–50.

  15. HORNE H.W., PAUL D.P., MUNRO D.: Fertility studies with traumatic injuries of the spinal cord and cauda equina. In: New Eng. J. Med., 1948, 237: 959–961.

  16. JONAS D., LINZBACH P., WEBER W.: The use of midodrin in the treatment of ejaculation disorders following retroperitoneal lymphadenectomy. In: Eur. Urol., 1979, 5: 184–187.

  17. LERICHE A., BERARD E., VAUZELLE J.L., MINAIRE P., GIRARD R., ARCHIMBAUD J.P., BOURRET J.: Histological and hormonal testiculars changes in spinal cord patients. Congrès international de Paraplégie de Toronto 1976. In: Paraplegia, 1977–78, 15: 274–279.

  18. MORALES P., HARDIN J.: Scrotal and testicular temperature studies in paraplegia. In: J. Urol., 1958, vol 79, no6, june: 972–976.

  19. OHL D.A., BENNETT C.J., MC CABE M., MENGE A.C., MC GUIRE E.J.: Predictors of success in electroejaculation of spinal cord injured men. In: J. Urol., 1989, 142, 1483–1486.

  20. OTANI ET AL.: A paraplegic fathering a child after an intrathecal injection of neostigmine: Case report. In: Paraplegia, 1985, 23: 32–37.

  21. SARKARATI M., ROSSIER A.B., FAM B.A.: Experience in vibratory and electroejaculation techniques in spinal cord injury patients: a preliminary report. In: J. Urol., 1987, 138: 59–62.

  22. SIOSTEEN A., FORSSMAN L., STEEN Y., SULLIVAN L., WICKSTR OM: Quality of semen after repeated ejaculation treatment in spinal cord injured man. In: Paraplegia, 1990, 28: 96–104.

  23. SPIRA R.: Artificial insemination after intrathecal injection of neostigmine in a paraplegic. In: Lancet, 1956, 1: 670–671.

  24. THOMAS R.J.S., MC LEISH G., MC DONALD G.: Electroejaculation of the paraplegic male followed by pregnancy. In: Med. J. Australia, 1975, 2: 798–799.

  25. TSUJI I., KNAKAJIMA MORIMOTO: The sexual function in patients with spinal cord injuries. In: J. New Ment. Dis., 1960, 131: 121–123.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leriche, A., Monnet, MF., Pogu, B. et al. Spermatogénèse et Paraplégie. Androl. 4, 133–141 (1994). https://doi.org/10.1007/BF03034278

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03034278

Mots Clés

Key-words